Paper short abstract:

Based on the comparative analysis of the activities of Molecular Tumor Boards in North America and Europe, the paper explores the co-production of data and their interpretation within these collective forums devoted to the discussion of the results of the genomic analysis of patient tumors.

Paper long abstract:

The adoption of high-throughput technologies in oncology has led, among other things, to the establishment of a new kind of institutions, referred to generically as Molecular Tumor Boards. MTBs provide a forum for clinicians, molecular biologists, and bioinformatics specialists to discuss the results of the genomic analysis of patient tumors, and make therapeutic recommendations on that basis. To analyze sequencing and gene expression data, MTBs resort to a heterogeneous set of evidential resources, including a number of genomic databases, publications, clinical trial results, previous experience with other patients, and basic knowledge about mutations and genetic pathways, all to be related to the singular clinical trajectory of individual patients. While individual MTBs share a common purpose of providing an "informed" data interpretation, the means to reaching that goal differ from one MTB to the other, from the actual composition of the MTBs, to the extent to which molecular results are taken for granted or questioned, the resort or not to prioritization algorithms, the extent to which they are followed, and pragmatic considerations such as access to specific drugs. Based on the comparative analysis of the activities of several MTBs in North America and Europe, the paper explores the co-production of data and their interpretation within these institutions., emphasizing their situated aspects, and in particular how the definition of what counts as relevant data is not only an input for data interpretation, but also the outcome of interpretative practices grounded in the definition of what may count as actionable molecular alterations.